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FOCIS Member Society Application

Fields with a star (*) are required.

Formal Name of Society or Organization: *
Mission statement/primary objective: *
Approximate number of members: *
Classes of Membership: (ex: fellow, trainee member, junior member, etc.)
Membership in National or Multi-national bodies:
Certification, if available (e.g. national, European, international, larger societies):
Our organization is: *


(please explain):
Please consider our organization for: *


President/Chair:
Name: *
Designation:
Title:
Address: *
 
City: *
State: *
Zip/Postal Code: *
Country: *
Phone: *
Fax:
E-mail: *
 
Chief staff officer/main office contact:
Name: *
Designation:
Title:
Address: *
 
City: *
State: *
Zip/Postal Code: *
Country: *
Phone: *
Fax:
E-mail: *

Upcoming meetings (name and date/year):
1. *
2.
3.
4.
 
Other future activities/educational programs (name and date):
1.
2.
3.
4.
 
Recent Meeting History (date, location, number of attendees):
1. *
2.
3.
 
Please attach as a Word or PDF document:

Roster of current officers, including address, telephone, fax and e-mail address


Copy of current Constitution and/or Bylaws


Letter of recommendation from FOCIS leader*

(This leader can be a current or past FOCIS Chair, Vice Chair, Secretary/Treasurer, Committee Chair or Steering Committee Representative. For a list of FOCIS Leaders, please click here.)

*Note: This letter can also be sent via post to:
FOCIS Executive Office
11950 West Lake Park Dr.
Suite 320
Milwaukee, WI 53224
If you need to make more attachments then space provides, please click here to send them as e-mail attachments. If you are attempting to upload files larger than 5 MB, please remove your attachments and click here to contact the FOCIS Executive Office.
Please click only once. Your attachments may take a minute to upload.


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